'When you hear hoofbeats, think of horses not zebras' - the old adage is well-known to GPs but what should you do when faced with a zebra, not a horse? Consultant cardiologist Professor Robert Tulloh and GP Dr Louise Tulloh kick off our new series with their advice on how to catch Kawasaki disease in general practice.

Hospitals and GPs urged to cooperate to catch out health tourism

Hospitals have been told to set up ‘formal’ relationships with GPs aimed at idenifying when patients should be charged, in a move GP leaders branded an 'additional burden' on practices.

Department of Health guidance on new charging regulations, which come into effect later this year, 'strongly recommend’ that NHS bodies that should charge patients appoint a designated 'overseas visitor manager’ (OVM) to liaise with practices.

Among a range of stricter rules on charging coming into effect this autumn, hospitals are from 23 October required to recover an estimate of the charges in advance of treatment 'unless doing so would prevent or delay the provision of immediately necessary or urgent services'.

The guidance says: 'OVMs should consider establishing formal contacts with local GPs to aid this process, which can be used by them as a useful tool in identifying potential chargeable overseas visitors who have to pay for treatment.'

And, although it adds it is 'the relevant body’s duty, not the GP’s, to establish entitlement for free NHS hospital treatment', it says GPs should aid in the process.

The document says: 'GPs are encouraged to help inform the process of identifying overseas visitors by indicating on referral letters when they understand a patient is not ordinarily resident in the UK, or is an EHIC holder, and inform patients that they may be chargeable for some hospital services.

'GP surgeries could also be encouraged to display posters regarding entitlement to NHS hospital treatment,' it adds.

The guidance points out that simply 'being registered with a GP, or having an NHS number, does not give a person automatic entitlement to access free NHS hospital treatment'.

It advises OVMs to 'ensure that local GPs understand this so that they do not unintentionally misinform their patients regarding hospital charges and so that where possible they identify in the referral letter any patient that may be an overseas visitor'.